title: Metformin and pioglitazone in polycystic ovarian syndrome: a comparative study.
abstract: OBJECTIVE
  To evaluate the effect of metformin and pioglitazone on insulin resistance, ovulation and hyperandrogenism in women with PCOS.
  
  
  METHODS
  100 patients of age 18-30 years were included in this randomised double blind trial for treatment with either metformin or pioglitazone for a period of 6 months.
  
  
  RESULTS
  Administration of metformin and pioglitazone for 6 months revealed that 50 % of the patients achieved menstrual cyclicity. A decline in F-G grading for hirsutism within the both the groups was observed. The lipid profile also showed a decrease in total cholesterol, an increase in HDL-C, a decrease in VLDL-C levels but more so in the pioglitazone group. HOMA-IR declined more than 50-55 % with pioglitazone and 15 % with metformin. Thus, pioglitazone may be a better treatment option as far as protection from tendency to development of diabetes is conscerned. The rise in serum SHBG levels and decline in free androgen index and L/H ratio are more remarkable with pioglitazone (P < 0.05). Ovulation was restored in 44.2 and 56 % of patients on metformin and pioglitazone, respectively.
  
  
  CONCLUSIONS
  Pioglitazone may be a new alternative for use in women with PCOS, providing more metabolic and reproductive benefits and possibly protection from developing diabetes and cardiovascular problem.
authors.affiliation: Department of Obstetrics & Gynecology, Gandhi Medical College, Secunderabad, 21-7-634, Chelapura, Secunderabad, Hyderabad-2, Andhra Pradesh India.
authors.forename: Shah
authors.initials: S
authors.lastname: Sangeeta
keywords: Hyperandrogenism; Insulin resistance; Ovulation; Pioglitazone metformin; Polycystic ovarian disease